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<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<title></title>
</head>

<body>
<form method="post" action="%%FormAction%%" class="myForm">
<!--
Do not modify the NAME value of any of the INPUT fields
the FORM action, or any of the hidden fields (eg. input type=hidden).
These are all required for this form to function correctly.
-->
<dl>
	<dt>Your Name:</dt>
	<dd><input type="text" name="myname" value="" /></dd>

	<dt>Your Email:</dt>
	<dd><input type="text" name="myemail" value="%%Email%%" /></dd>

	<dt>Friends Name:</dt>
	<dd><input type="text" name="friendsname" value="" /></dd>

	<dt>Friends Email:</dt>
	<dd><input type="text" name="friendsemail" value="" /></dd>

	<dt>&nbsp;</dt>
	<dd><textarea name="introduction" rows="5" cols="30">Hey, I found this really interesting newsletter that I thought you might like to read for yourself.</textarea></dd>

	<dt>&nbsp;</dt>
	<dd><input type="submit" value="Send To Friend" /><br/>%%LNG_Form_Branding%%</dd>
</dl>

</form>
</body>
</html>
